Abstract

MEDA VIMARGAGAMANA IN ASTHI-MAJJA DHATU AND POSTERIOR INTERVERTEBRAL DISC BULGE: AN INTEGRATIVE CONCEPTUAL REVIEW

*Shukla Vd. Shubham, Alawa Dr. Akanksha, Patidar Dr. Muskan, Shukla Dr. Umesh, Jain Dr. Salil K, Mishra Dr. Neha

Abstract

Background: Intervertebral disc degeneration is a major contributor to chronic low back pain and radiculopathy and remains a leading source of disability worldwide. Although mechanical loading remains central to disc pathology, growing evidence indicates that metabolic dysfunction, obesity-related inflammation, adipokine dysregulation, and vertebral marrow fat may also contribute to disc matrix failure and impaired repair. In Ayurvedic physiology, tissue homeostasis is understood through the integrated relationships among Dosha, Dhatu, Agni, and Srotas, and pathological disruption of these channels is described as Srotodushti. Objective: To develop an integrative conceptual framework for Meda Vimargagamana within the Asthi-Majja axis and to examine its theoretical correspondence with immunometabolic and degenerative mechanisms implicated in intervertebral disc pathology.Materials and Methods: A narrative conceptual review was conducted using classical Ayurvedic sources, including the Caraka Saṃhitā, Suśruta Saṃhitā, and Aṣṭāṅga Hṛdaya, together with contemporary biomedical literature retrieved from indexed databases on intervertebral disc degeneration, adipokine biology, marrow adiposity, and immunometabolic spinal mechanisms. Results: Classical Ayurvedic literature describes Meda Dhatu as functionally interconnected with Asthi and Majja and recognizes Meda as a root of the Asthivaha Srotas, supporting a systemic relationship between lipid homeostasis and deeper structural tissues. Contemporary evidence similarly suggests that intervertebral disc degeneration is not solely a mechanically driven disorder but also involves inflammatory and metabolic imbalance, including adipokine-mediated signaling, oxidative stress, extracellular matrix catabolism, and altered nutrient exchange across the cartilaginous endplate. Studies of adjacent vertebral marrow further report associations between increased vertebral bone marrow fat and biochemical changes in neighboring discs, supporting a plausible disc-endplate-bone marrow interaction. Within this integrative model, Meda Vimargagamana may be interpreted as a conceptual analogue of pathological lipid deviation and local metabolic obstruction contributing to structural disc failure. Conclusion: Posterior intervertebral disc bulge can be framed conceptually not only as a localized biomechanical event but also as a downstream structural expression of broader immunometabolic disturbance. This interpretation is hypothesis-generating and integrative rather than clinically validated, and it requires direct translational and longitudinal investigation.

Keywords: Vimargagamana, Intervertebral Disc Bulge, Disc Bulge, Immunometabolism.